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Title: How much synthetic oxytocin is infused during labour? A review and analysis of regimens used in 12 countries
Authors: Daly, Déirdre 
Minnie, Karin C.S. 
Blignaut, Alwiena J. 
Blix, Ellen Störe 
Vika Nilsen, Anne Britt 
Dencker, Anna 
Beeckman, Katrien 
Groß, Mechthild M. 
Pehlke-Milde, Jessica 
Grylka-Baeschlin, Susanne 
Koenig-Bachmann, Martina 
Clausen, Jette Aaroe 
Hadjigeorgiou, Eleni 
Morano, Sandra 
Iannuzzi, Laura 
Baranowska, Barbara 
Kiersnowska, Iwona 
Uvnäs-Moberg, Kerstin 
Major Field of Science: Medical and Health Sciences
Field Category: Clinical Medicine
Keywords: Oxytocin infusion regimens;International Units;Drug dose escalation;Drug dose regimen;Drug infusion;Drug administration
Issue Date: 7-Jul-2020
Source: PLoS ONE, 2020, vol. 15, no. 7 July, articl. no. e0227941
Volume: 15
Issue: 7
Journal: PLoS ONE 
Abstract: Objective To compare synthetic oxytocin infusion regimens used during labour, calculate the International Units (IU) escalation rate and total amount of IU infused over eight hours. Design Observational study Setting Twelve countries, eleven European and South Africa. Sample National, regional or institutional-level regimens on oxytocin for induction and augmentation labour Methods Data on oxytocin IU dose, infusion fluid amount, start dose, escalation rate and maximum dose were collected. Values for each regimen were converted to IU in 1000ml diluent. One IU corresponded to 1.67μg for doses provided in grams/micrograms. IU hourly dose increase rates were based on escalation frequency. Cumulative doses and total IU amount infused were calculated by adding the dose administered for each previous hour. Main Outcome Measures Oxytocin IU dose infused Results Data were obtained on 21 regimens used in 12 countries. Details on the start dose, escalation interval, escalation rate and maximum dose infused were available from 16 regimens. Starting rates varied from 0.06 IU/hour to 0.90 IU/hour, and the maximum dose rate varied from 0.90 IU/hour to 3.60 IU/hour. The total amount of IU oxytocin infused, estimated over eight hours, ranged from 2.38 IU to 27.00 IU, a variation of 24.62 IU and an 11-fold difference. Conclusion Current variations in oxytocin regimens for induction and augmentation of labour are inexplicable. It is crucial that the appropriate minimum infusion regimen is administered because synthetic oxytocin is a potentially harmful medication with serious consequences for women and babies when inappropriately used. Estimating the total amount of oxytocin IU received by labouring women, alongside the institution’s mode of birth and neonatal outcomes, may deepen our understanding and be the way forward to identifying the optimal infusion regimen.
ISSN: 1932-6203
DOI: 10.1371/journal.pone.0227941
Rights: © 2020 Daly et al.
Attribution-NonCommercial-NoDerivatives 4.0 International
Type: Article
Affiliation : Trinity College Dublin 
North-West University 
Oslo Metropolitan University 
Western Norway University of Applied Sciences 
University of Gothenburg 
Vrije Universiteit Brussel 
University of Antwerp 
Hannover Medical School 
Zurich University of Applied Sciences 
Health University of Applied Sciences Tyrol 
Copenhagen University College 
Cyprus University of Technology 
University of Genoa 
Bournemouth University 
Centre of Postgraduate Medical Education 
Medical University of Warsaw 
Swedish University of Agriculture 
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